You injured your knee badly and you underwent surgery (ligament reconstruction). Your surgery is planned for next week, or it was 2 weeks ago, 3 months ago, 1 year ago…But you all have the same question: When can I return to sport safely?
Your surgeon told you to wait for 6 months, a friend told you to wait fofr 3 months, a other doctor said 1 year. And you’re a lost…
This video is there to help you better understand the process and decide whether it is safe for you or not to return to sport.
Return to sport is one step inside a continuum of rehabilitation post-surgery. Let’s review these steps/phases together and ask yourself if you achieved the expected outcomes at the end of each phase.
Phase 1: Post-surgery
Phase 2: Return to daily life activities
Phase 3: Strengthening
Phase 4: Return to Running
Phase 5: Return to Sports"
1. In the post-surgery phase
The objective is to decrease the swelling and pain, restore mobility and activate the muscles. Your knee is often swollen and painful after the anterior cruciate ligament reconstruction surgery.
Within the first 3 weeks, protect your knee with the cast, and crutches to help decrease the swelling and pain. Practice some light exercises by yourself or under the guidance of a qualified physiotherapist (highly recommended) to help restore mobility and muscle activation.
Within the first 3 weeks, protect your knee with the cast, and crutches to help decrease the swelling and pain. Practice some light exercises by yourself or under the guidance of a qualified physiotherapist (highly recommended) to help restore mobility and muscle activation.
To consider the end of this phase, ask yourself: Am I able to walk without crutches and cast with confidence, full knee extension and no pain or increased effusion after 10’ of walk? If not, please check and ask for the support of a physiotherapist.
2. Return to daily life activities
You must be able to walk before returning to running or engaging in any sport. First, you need to walk normally at home and in an outdoor environment without limping.
Some examples to improve walking gait: Walk On Obstacles (i.e., marker) using hip flexion, knee raise and knee flexion; retro walking (or backward walking) helps to improve knee extension.
To have a normal walking gait, you need to control your pain and swelling in the first place. The abovementioned exercises can increase muscle strength and articular range of motion with proper pain and swelling management.
To consider the end of this phase, ask yourself: Can I walk normally (no limping) confidently, move easily from standing to sitting or lying position, and do a stationary bike? Am I able to fully extend or bend my knee to 120-130 degrees?
If not, please check and ask for the support of a physiotherapist.
3. Muscle strength and balance
The knee joint structures must be strong enough to endure the stresses of running, where your knee must absorb at least 2-3 times your body weight for each step. Strengthening exercises should prioritize on the hamstrings, quadriceps, calves, and other muscles such as glutes, abductors, adductors, core, etc. (For example, deadlift, hamstring work with a KB Ball, etc.)
After being able to walk normally and engage in most of the daily activities without problem you should follow a well-designed and progressive strengthening program of 6-10 weeks minimum (under the guidance of a qualified physiotherapist if possible) to restore the strength and stability on your injured leg.
To consider the end of this phase you should ask yourself : Am I able to do 10 reps of these 3 exercises :
1 - Unipodal Heel Raise
2 – Single Leg Bridge
3 – Pistol Squat
If not, please check and ask the support of a physiotherapist.
4. Return to Run
Here, it is necessary to follow a progressive return to running protocol to help the body and the brain to readapt to the load.
This progressive return to run protocol should be design for 3-6 weeks and be supervised and guide by a qualified physiotherapist to be sure that you restore an optimal running technique"
5. Sports activity
You may initially find returning to sports activities challenging, unsettling, and possibly "odd." However, returning to sports activities is achievable if you choose a good milestone early on and have a proper rehabilitation that includes all the required phases.
In summary, returning to running after 3 to 5 months following the anterior cruciate ligament reconstruction surgery is reasonable and doable. And returning to sports activities between 6 to 9 months following the anterior cruciate ligament reconstruction surgery is also reasonable.
However, it’s significantly important to carefully consider each individual's actual capacity and functional as well as physical ability. The decision to return to running or to sport should be based on objective criteria of reconditioning. Before running, be sure you are confident in all the daily life activities (walking, sitting deep, stairs), restore the appropriate knee ROM (full knee flexion– full extension, sufficient strength), balance and force-absorption ability.
Prior to returning to sport, be sure that you followed an appropriate and progressive running protocol, that you feel confident in jumping and landing on one leg, changing direction and sprinting, and that you are not afraid of any movement involving your knee.
A qualified sports physiotherapist will help you to objectively decide if you are ready to run and practice your sport again. We will guide you to follow a progressive and adaptable return to run protocol as well as a progressive sports-specific readaptation to help you feel more confident to resume your sport.
Do not hesitate to contact us if you need treatment advice and guidance from the leading experts at IRC.
Disclaimer: This article is not intended to replace consultation with a healthcare professional who will discuss the best treatment option for you based on your specific needs and circumstances.
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